Compartment Syndrome and Shin Splints

Chronic compartment syndrome results from repetitive trauma and overuse. The following are possible causes:

                Running - especially on hard surfaces in boots / poor shoe inserts

                Repetitive stress from running, rucking, impact to shin area

Some of the symptoms of Compartment Syndrome are swelling in the lower legs, pain, numbness and can result in permanent nerve damage.

Here is the reader's digest version of the symptoms / treatment from another reader who had Compartment Syndrome and thought he had shins splints:

I had pain in the lower legs when running.  It only induced if I ran faster than a 9 min/mile, and the onset of the pain was directly proportional to how much faster than 9 min/mile I ran.

If I kept running after the onset of the pain, (ie., tried to run through it), the muscles would seize and I'd be unable to flex my foot...creates a "slapping" sound when the foot strikes the ground.  This is a big indicator that it is NOT shins splints.

The seized muscles would release and the acute pain / swelling would cease within an hour after I finished running. (If I'd had shin splints before, I'd have known that shin splint pain doesn't just go away).  The residual pain would go away within 24 hours; thus I was running every other day.

Compartment Syndrome is basically the fascia surrounding the muscles in question no longer expands to allow the muscle to expand during
exercise.  With nowhere to expand, the blood flooding the exercised muscle puts pressure on the blood vessels and nerves causing the
above symptoms.

After being diagnosed, I asked the doctor, "what if I just run 9 min/miles for the rest of my life?"  The doc said that the symptoms would induce at a slower and slower threshold and eventually it WOULD NOT RELEASE and I could lose portions of the muscle or the lower leg.  He then instructed me to STOP RUNNING until after surgery.

There's no known reason for ECS, (I thought it might be a function of my age, 45 but my surgeon does work with the Ohio State football team and says that he does about 3 surgeries on Buckeye football players every year and their late teens/early 20's).  The test for CS was actually more
painful than the surgery.  The surgery was fairly simple, they slit my lower legs and cut the fascia around the lower compartments then went under the skin and cut the fascia around the upper compartments.  

That is why when people ask about running through the pain and sucking up shin splints, it is always best to think before you run again.  It could be something an easy warm up stretch will help, but then again it could be something that requires time and healing or even surgery.  If you are having some of the CS symptoms above, you should consider not running and seeing a doctor.

BUT there is more than one way to treat ECS - how about Physical Therapy with NO SURGERY - here is an addition from another reader:

Thanks for the emails - as you can see if you cannot run - stop running - see a doctor - and realize you always have options to surgery.